系统免疫炎症指数在三阴性乳腺癌复发转移中的预测价值

目的探讨术前系统免疫炎症指数(SII)在三阴性乳腺癌(TNBC)复发、转移中的预测价值。方法收集2011-01~2019-09中国人民解放军联勤保障部队第九〇四医院甲状腺乳腺外科收治的100例女性原发性TNBC患者临床资料,计算SII数值,应用受试者工作特征曲线(ROC)确定最佳临界值,据此将其分为高SII组(42例)和低SII组(58例)。采用Kaplan-Meier法绘制生存曲线,log-rank检验进行术后复发、转移情况的单因素分析,应用Cox回归模型进行多因素分析,探讨影响TNBC预后的危险因素。结果高SII组和低SII组TNBC患者术后1年、3年、5年无病生存(DFS)率分别为81.0%、46.3%、41.0%和98.3%、84.1%、76.0%,平均DFS时间分别为50.0个月和83.1个月,低SII组患者的DFS预后显著优于高SII组(P<0.05)。单因素分析显示T分期、N分期、pTNM分期、Ki-67、术前SII与TNBC患者术后的复发、转移情况具有关联性(P<0.05)。Cox回归分析结果显示,较高的T分期(HR=7.806,95%CI=3.290~18.523,P=0.000)、N分期(HR=3.526,95%CI=1.763~7.050,P=0.000)和术前SII(HR=3.440,95%CI=1.763~6.710,P=0.000)是影响TNBC患者DFS预后的危险因素。结论SII与TNBC患者的DFS预后相关,术前较高水平的SII是影响TNBC患者术后发生复发、转移事件的独立危险因素。SII可便捷、有效地评估患者预后,具有临床应用价值。

Predictive value of systemic immune-inflammation index in recurrence and metastasis of triple-negative breast cancer

Objective To explore the predictive value of preoperative systemic immune-inflammation index(SII)in the recurrence and metastasis of triple-negative breast cancer(TNBC).Methods The clinical data of 100 female patients with primary TNBC admitted to the Department of Thyroid and Breast Surgery,the 904th Hospital of Joint Logistic Support Force of the Chinese People′s Liberation Army from January 2011 to September 2019 were collected.The patients′SII values were calculated,and their best cut-off values were determined by receiver operating characteristic curve(ROC).The patients were divided into high SII group(42 cases)and low SII group(58 cases)according to their different best cut-off values.Kaplan-Meier method was used to draw the patients′survival curve,and log-rank test was used for univariate analysis of postoperative recurrence and metastasis of triple-negative breast cancer,and Cox regression model was used for multivariate analysis to explore the risk factors affecting the prognosis of TNBC.Results The 1,3,and 5-year disease-free survival(DFS)rates of TNBC patients after surgery in the high SII group and the low SII group were 81.0%,46.3%,41.0%and 98.3%,84.1%,76.0%,respectively,and the average DFS time was 50.0 and 83.1 months,respectively.The prognosis of DFS in the low SII group was significantly better than that in the high SII group(P<0.05).Univariate analysis showed that T staging,N staging,pTNM staging,Ki-67 and preoperative SII were associated with postoperative recurrence and metastasis of TNBC patients(P<0.05).The results of Cox regression analysis showed that higher T staging(HR=7.806,95%CI=3.290-18.523,P=0.000),N staging(HR=3.526,95%CI=1.763-7.050,P=0.000)and preoperative SII(HR=3.440,95%CI=1.763-6.710,P=0.000)were the risk factors affecting the prognosis of DFS in TNBC patients.Conclusion SII is related to the prognosis of DFS in TNBC patients,and the higher level of preoperative SII is an independent risk factor affecting recurrence and metastasis of TNBC patients after surgery.SII can evaluate the prognosis of the patients conveniently and effectively,and has clinical application value.